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CCEMTP -
Liberty Ambulance Critical Care Paramedic Study Guide
| Question | Answer |
|---|---|
| What lab value is used to assess the therapeutic level of heparin? What are the desired levels of this test? | PTT 25-38 Seconds |
| PT of_____seconds is an indicator for coumadin therapy. | PT</p><p>less than 2 seconds</p> |
| What is the normal PT value? | 11-15 Seconds |
| Bucking on the ventilator may mean... | <p>Hypoxia</p><p>Patient needs suctioning</p> |
| What are signs and symptoms of ventilator toxicity? | Pulmonary infiltrates VQ (<span id="result">Ventilation/perfusion) </span>mismatch with decreased oxygen transfer |
| Patients with ARDS and or COPD may need what adjusted when on a ventilator? | PEEP |
| What is the proper dose for fentannyl? | 3-5 mcg/kg |
| What is the potential adverse effect of fentanyl? | May cause chest wall spasms |
| When performing RSI, you should preoxygenate for ____ minutes. | 2 minutes |
| What are the different Meningitis types and the signs/symptoms of each? | p>viral and bacterial</p><p> </p><p>headache, neck pain, inability to straighten legs and flex neck</p> |
| Hepatitis B is transmitted by _____? | Bloodborne |
| Hepatitis A is transmitted by _____? | Oral - Fecal |
| What is the maximum PIP: Peak inspiratory pressure ? Which two conditions may this be increased for? | < 40 cm of H<sup>2</sup>O may be increased for ARDS and COPD |
| What is the proper ventilator rate for an adult? | 10-20 bpm |
| What is the sensativity of Ventilators? | -2 cmH<sup>2</sup>0 |
| How often should a "sigh" be set on the ventilator? | 1.5 to 2 times the pts tidal volume deliver 100 breaths or 7 mnutes |
| What is the normal tidal Volume? | 500-600 or 10-15 ml/kg |
| What is the proper flow rate for ventilators? | 30-60 LPM |
| List 5 types of abnormal respirations | Depression, Failure, Insufficiency, Arrest, V/Q defect or mismatch |
| Apneustic respirations are caused by... | Respiratory Center Lesions |
| Kussmaul Respirations are caused by | Metabolic Problems |
| What are reasons for RSI? | Full Stomach Theory, Increased ICP, Overdose, Burns, Chest Trauma, GI Bleed |
| Biot's respirations are caused by | CNS Dysfunction Meningitis |
| Cheyne-Stokes respirations are caused by... | Increased ICP, CHF, Renal Failure, Meningitis, Overdose |
| What is thermodilution? | A way to measure cardiac output by placing cold solutionthrough Swann-Ganz, computer calculates CO by distrubution of cold fluid. |
| What is the proper locations for chest tubes? | hemo - 5th rib mid - axillary pnemo - 2-3 third rib mid-clavicular |
| Tuberculosis is caused by | Bacteria |
| What are the signs and symptoms of tuberculosis? | Cough,night sweats, hemoptysis, fever, pleurisy, anorexia, weight loss |
| What is the best way to break the circle of transmission? | Hand Washing |
| What is a normal PTT - Partial thromboplastin time value? | 60 - 80 seconds |
| What is the normal specific gravity for a urinalysis? What does a specific gravity mean? | 1.003 -1.030Nephrosis = kidney diseaseDiabetesfluid loss |
| What is the normal urine out put for Adult, Ped, Neonate? | Adult - 30-70 cc/hrped - 1cc/kg/hrneonate - 2cc/kg/hr |
| Liver enzymes must be not more than? | 30 |
| What is a normal potassium level? | 3.5 - 5 |
| What is a normal sodium level? | 135 - 145 |
| What is the primary extracellular ion? | sodium |
| What is the primary intracellular ion? | potassium |
| Herpes Zoster in the Adult is also called? | shingles |
| What is the normal BUN (Blood urea nitrogen: Creatine ratio? What would an abnormal ratio indicate? | 10:1 Indicative of renal failure |
| ABGs are useful in determining... | Determining metabolic vs. respiratory acid/base abnormalities |
| What are normal platelet levels and what are they used to assess? | 150,000 - 400,000 per cubic millimeter of blood mm3To diagnose and/or monitor bleeding and clotting disorders |
| How do you perform a tactile fremitus assessment by palpation? | palpate the patient's chest wall while the patient takes a breath and says "99" |
| What is consolidation? | Fluid or air spaces - commonly found in pneumonia |
| List some abnormal lung sounds... | Wet vs dry, bronchial vs vesicular, resonance, diminished or absent, crackles, wheezes, rhonci, stridor, friction rub |
| Lungs sounds can be ______ or _____ pitched.Which is normal ? | High or Low - Low is normal |
| What are the durations of lung sounds? | Long, Short, continuous, interrupted |
| What are the two factors that affect lung sounds? | Distance from source, obesity, consolidation, atlactasis, Bronchiectasis |
| What are the Lungs landmarks? | Apex 2-4 cm inner 3rd of anterior clavicleBase 6th rib mid-clavicular8th rib mid axillary |
| What is the correct procedure/ location for a tracheostomy? | 1 cm incision superior to the suprasternal notch. |
| What is the proper management of a decannulation of a trached patient's tube? | Intubate, may need pediatric blade or trach spreaders to visualize. |
| What are causes of tachypena? | ASA poisoning, Lesions to respiratory center, Fever |
| A Fever will increase respirations by? | 4 breaths per minute per degree |
| What are some causes of false SaO2 readings? | CO poisoning , temperature, extreme vasconstriction |
| What are some methods of decreasing ICP? | Decrease external stimulation, insure quiet invironment, pull slouching patient to top of bed, elevate head of bed, shut off bright lights, align head and neck, surgical intervention. |
| What medications are used for decreasing ICP? | Sedation,Paralytics, Diuretics, Steroids, barbiturate-induced coma |
| What does the phrenic nerve ( A nerve, arising from the third, fourth, and fifth cervical (cervical plexus) segments of the spinal cord) do? | Innervates disphragm (stimulates to action) |
| What is an additive used for multiple blood transfusions? | Citrate is the anticoagulant used in blood products |
| What is IMV? | Intermittent mandatory ventilation |
| What are signs and symptoms of increasing ICP? | Restlessness, Agitation, Disorientation, Occasional PVCs, Hypoxia |
| What is AV? | assisted ventilations |
| What is ACV ? | Assisted Controlled Ventilations |
| What are 3 ways to look at CFS Leakage? | Halo Test: Oral or Mouth, Rhinorrhea - commonly referred to as runny nose, consists of a significant amount of nasal fluid otorrhea - Ear discharge (otorrhea) is drainage exiting the ear |
| When obtaining a PAWP the balloon should not remain inflated longer than _____. | 30 seconds |
| PTT of _____seconds is an indicator for heparin therapy. | 25-38 |
| PAP value - pulmonary artery pressure | 15-30 mmHg systolic, 8-15 mmHg diastolic, 10-20 mmHg mean pressure ( page 579 ) |
| Procedure for deactivating an Automatic internal cardiac defibrillator. | 1)Palpate the boundaries2)Approach from directly above with cardiac magnet3)Synchronous tone lasts 30 seconds followed by a continous tone=unit off4)Remove magnet straight up. |
| Biot's (ataxic) breathing is caused by | Meningitis, CNS dysfunction |
| Which antiarrhythmic is a Class II (beta blocker) | Propanolol (Inderal) |
| The probability that the test will be negative in the absence of disease. | SPECIFICITY |
| T/F:Venous blood never passes through the lungs during right to left cardiac shunting. | False |
| Mean arterial pressure (MAP), minus intracranial pressure (ICP), equals: | Cerebral perfusion pressure (CPP) |
| Normal PR interval | .12 - .20 |
| The primary intracellular cation is __________ and the primary extracellular cation is __________. | Potassium (K+)Sodium (Na+) |
| Nipride must be ______________ and NTG must be in a _____________, be sure to saturate the IV tubing. | wrapped in foil , glass bottle |
| Class I antiarrhythmics | Quinidine, Pronestyl, and Norpace |
| O2 cylinder capacityG cylinder has how many liters | 5300 liters |
| The correct procedure for a tracheostomy incision is ____ superior to the _____________. | 1cm, suprasternal notch |
| A common problem of specimen collection associated with the breakdown or RBCs and subsequent release of hemoglobin is known as: | Hemolysis |
| Correct placement of the IABP catheter is at the level of the __________, 1-2cm distal to the __________, above the renal arteries, viewed on a chest film; the distal end will be seen at the ___ or ___ intercostal spaces. | aortic arch, subclavian, 2nd or 3rd |
| ____________ should be monitored during transport to assure that the distal tip of the IABP has not migrated into the ____________ or occluded the __________. | Left radial pulseleft subclaviansubclavian |
| Augmented diastolic should be more than the ________ ______. | unassisted systolic. |
| Universal blood donor | O negative |
| True/False: Migraines can be treated with beta blockers. | True |
| You can determine a _____ in a 12lead ECG by V1 with a classic RSR prime. | Right Bundle branch block |
| Ketamine: *Strong __________ with hypnotic effect.*May be used in ______ ________.*Emergence reaction up to ___ hrs post administration.*Dose? | bronchodilatorstatus asthmaticus242 mg/kg |
| The shape and appearance of a waveform is referred to as the ___________. | morphology |
Created by:
perkida